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1649044058
MOONRISE THERAPY PLLC
EVANSTON, IL
NPI
1649044058
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Entity Type
Organization
Authorized Contact
DARREN DIAMOND
Manager
518-708-5405
Organization Subpart ?
No
Primary Taxonomy
103T00000X Psychologist
Enumeration Date
2023-11-07
Last Update Date
2023-11-07
Business Address
MOONRISE THERAPY PLLC
708 CHURCH ST STE 251
EVANSTON, IL 60201-3840
Phone number: 773-517-8105
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Mailing Address
MOONRISE THERAPY PLLC
708 CHURCH ST STE 251
EVANSTON, IL 60201-3840
Phone number: 773-517-8105
Copy
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